Chronic kidney disease in children in Turkey.
To determine the incidence, etiology and treatment patterns of chronic kidney disease (CKD) in children a questionnaire was sent to pediatric nephrology centers in Turkey, asking them to report patients under the age of 19 years who had estimated glomerular filtration rates (GFRs) of <or=75 ml/min per 1.73 m(2) body surface area, diagnosed in 2005. Twenty-nine centers reported 282 patients (123 female/159 male; mean age 8.05 +/- 5.25 years). Urological problems such as vesicoureteral reflux (18.5%), obstructive uropathy (10.7%) and neurogenic bladder (15.1%) were the leading causes of CKD. The majority of the patients were in stage V (32.5%), IV (29.8%) or III (25.8%). Growth retardation (49.6%) and secondary hyperparathyroidism (72.4%) were very frequent. The GFR levels correlated positively with hemoglobin/hematocrit and calcium levels and negatively with phosphorus and parathyroid hormone (PTH) levels (P < 0.05). Renal replacement therapies were initiated in 35.8% of the patients, peritoneal dialysis in 23%, hemodialysis in 10.6% and transplantation in 2.2%. This was the first multi-center, epidemiologic study done in children with CKD in Turkey. The most striking result was the predominance of vesicoureteral reflux (VUR) or related urological problems as the underlying causes of CKD. Thus, early diagnosis and treatment of these conditions are of vital importance to decrease the incidence of CKD in children.
Bek
Kenan
K
Pediatric Nephrology, Ondokuz Mayis University, Kurupelit, Samsun 55100, Turkey. kenanbek2000@yahoo.com
Akman
Sema
S
Bilge
Ilmay
I
Topaloğlu
Rezan
R
Calişkan
Salim
S
Peru
Harun
H
Cengiz
Nurcan
N
Söylemezoğlu
Oğuz
O
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D015994:Incidence; D007223:Infant; D007674:Kidney Diseases / Q000453:epidemiology* / Q000209:etiology / Q000628:therapy; D008297:Male; D011795:Surveys and Questionnaires; D014421:Turkey / Q000453:epidemiology; D014517:Ureteral Obstruction / Q000150:complications / Q000453:epidemiology* / Q000628:therapy; D001750:Urinary Bladder, Neurogenic / Q000150:complications / Q000453:epidemiology* / Q000628:therapy; D014718:Vesico-Ureteral Reflux / Q000150:complications / Q000453:epidemiology* / Q000628:therapy